Healthy Sleep for Healthcare PROFESSIONALS & Students
Sleep is hard to come by for healthcare professionals (and even for students). Learn how to maximize your sleep, and how to recognize and combat some of today’s most common sleep disorders.
Just about every doctor and medical professional will tell you that quality, restorative sleep is absolutely necessary for good physical and mental health. Yet a third of adults in the U.S. report they get less sleep than the recommended seven hours per night, according to the Centers for Disease Control and Prevention (CDC). Up to 70 million Americans also suffer from sleep disorders such as insomnia or sleep apnea, according to recent estimates. This has led some experts to classify insufficient sleep as a public health problem, citing risk factors like heart disease, obesity, and reduced mental cognition.
Sleep deprivation does affect people unevenly. Even in best of times, many students and healthcare professionals face work conditions that make it difficult to get enough sleep. Long hours, double shifts, and 24/7 on-call commitments all contribute to sleep quality.
If you are a student or healthcare professional who struggles with sleep or sleep deprivation, this guide is for you. It looks at the importance of sleep and offers key resources specifically for medical students and healthcare workers. It discusses the benefits of good sleep, examines prominent sleep disorders, and the effects of sleep deprivation.
Why Sleep Matters: The Benefits of Good Shut Eye
We all know that sleep matters. But what do the advantages of quality sleep look like? What are the short-term benefits and long-term effects? This section lists ten common benefits of obtaining quality sleep and looks at some consequences of sleep deprivation.
| Benefits of Sleep | What Happens When We’re Sleep Deprived |
|---|---|
| Elevated Mood | According to WebMD, sleep deprivation can limit how your brain processes emotions. This can lead to more negative emotional responses throughout the day. It can also increase your chances of having a mood disorder. Quality sleep combats these effects and enhances your overall mood. |
| Sharper Cognition | A 2019 study found that uneven or interrupted sleep can severely limit your mental faculties and executive functions. If you are sleep deprived you may also suffer from inhibited alertness, limited attention, and reduced decision-making capacities. If you sleep well you are in a better position to stay focused and remain alert throughout the day. |
| Healthier Heart | Experts at the National Institutes of Health report that sleep significantly affects blood pressure and cardiovascular health. Lack of sleep can increase your risk for heart disease and other infectious ailments. Quality sleep reduces your risk of suffering a heart attack or stroke and can also lower your blood pressure. |
| Stronger Immune System | Studies show that even minor interruptions in sleep quality can limit the function of your immune system. For example, researchers at Carnegie Mellon University found that people who sleep less than seven hours a night were three times more likely to catch the common cold. Getting good, quality sleep keeps your immune system strong. |
| Better Learning Aptitudes | Students are especially prone to sleep deprivation and often see diminished academic performance as a result. Medical and healthcare students in particular tend to see a drop in their grade point averages along with limited memory processing when they don’t get quality sleep. |
| Increased Physical Activity | Along with diet, regular exercise is one of the most common recommendations health professionals give their patients. Insomnia and other sleep disorders reduce our motivation for physical activity, according to observational studies. Maintaining a quality, consistent sleep routine encourages regular exercise and physical activity. |
| Less Overall Stress | Increases in general stress and anxiety are closely linked to sleep deprivation. The National Sleep Foundation reports that quality sleep can reduce stress, while prominent sleep disorders like insomnia often contribute to elevated stress levels. |
| Better Diet and Appetite | If you suffer from a lack of sleep you are much more likely to have unhealthy eating habits. Sleep affects how we eat, what we eat, and how our body processes nutritional value. Good, quality sleep supports a healthy metabolism and reduces risk for obesity. |
| Increased Productivity | Working professionals who suffer from a lack of sleep often report feeling tired and sluggish throughout the day. Workers in industries like healthcare with extended or irregular hours are particularly susceptible to these trends. Quality sleep ultimately enhances professional performance. |
| Lower Risk of Diabetes | Quality, restorative sleep plays an important role in blood sugar control and insulin sensitivity, according to recent research. Along with healthy weight, these factors contribute to your risk of developing type 2 diabetes. Proper sleep can help reduce this risk by supporting the body’s natural processes. |
Common Sleep Disorders in Healthcare
Sleep apnea and insomnia are the two most common and pervasive sleep disorders. Insomnia refers to the inability to fall asleep or difficulty staying asleep. It can be a short-term, chronic, or periodic condition. People who suffer from insomnia often report trouble concentrating, increased irritability, and general sleepiness throughout the day, according to WebMD. Causes can include stress, changes in environment, and an inconsistent sleep schedule.
People who suffer from sleep apnea have trouble maintaining regular breathing patterns during sleep. This can occur due to snoring, relaxed throat muscles, or a failure of the brain to send proper signals to the muscles that control breathing. Like insomnia, sleep apnea can lead to drowsiness throughout the day and an inability to focus. Many people with sleep apnea use a continuous positive airway pressure (CPAP) machine to help regulate their breathing as they sleep.
Sleep apnea and insomnia both make it difficult to get quality sleep, especially for people who work hectic, high-stress environments like healthcare. These disorders keep you from getting the type of deep, restorative sleep you need to feel rested and energetic throughout the day. The can also upset your circadian rhythm, i.e., your body’s internal processes for distinguishing when you are awake and when you should be asleep.
How Sleep Issues Affect Students
Quality sleep can have a significant effect on students and many students struggle to keep good sleeping habits. A recent survey conducted by the American College Health Association found that nearly 25% of students regularly feel tired, drowsy, or sleepy during the week. Another study reports that sleep deprived students (and those with irregular sleep patterns) tend to demonstrate poorer academic performance than their peers, including lower grades and reduced cognitive output.
How does this happen? If you are a student you’re likely juggling varying class schedules, internships, work responsibilities, and impending deadlines. It can be difficult to strike a consistent, healthy balance and typically sleep is one of the first things to suffer. Working to complete assignments late at night can disrupt your body’s circadian rhythm and waking up early for work or morning classes can make it hard to keep your focus. This can lead to diminished academic and professional results.
If you are at student who struggles with these issues there are several things you can do. You have already taken the first crucial step by reading this guide: knowing how important quality sleep is and remaining aware of how sleep deprivation can affect your day-to-day go a long way. Beyond that, most professionals and academic counselors will offer advice similar to the points we discuss in the next sections. Diet, exercise, and a regular sleep routine can help you fight the consequences of sleep deprivation so you get the rest you need to succeed.
How Sleep Issues Affect Healthcare Professionals
Healthcare professionals are often subject irregular work schedules, shift changes, and high stress environments. Unsurprisingly, this can be a perfect recipe for sleep deprivation or interrupted sleep. Healthcare workers work on the frontlines, spending their days providing care and promoting the well-being of others. Many remain on call around the clock and may be called in at a time when most people are getting the rest and rejuvenation they need to succeed.
If you often find it difficult to prioritize your own needs and health you are not alone. Thirty-two percent of healthcare workers report that they do not get enough quality sleep. Even more alarming, between 30-70% of nurses sleep less than six hours before their scheduled shifts, according to a 2016 study. By contrast, the CDC recommends that healthy working adults get at least seven hours of quality, uninterrupted sleep each night.
With some healthcare professionals working night shifts or long doubles it can be especially difficult to get the rest you need to stay focused and alert on the job. Noise, general stress, and other industry-specific rigors all contribute to sleep deprivation and can lead to a greater risk of mistakes or negligence on the job, not to mention difficulty balancing work and family. Many healthcare workers often resort to intermittent napping throughout the day to avoid fatigue. This can help, but is no substitute for the deep, restorative sleep your body needs to stay healthy and rested.
How Can Those in Healthcare Get Better Sleep?
Below are several strategies for natural remedies, lifestyle changes, and medical intervention to help get your sleep on the right path. As always, you should consult your doctor or another health professional if you are seeking medical advice.
Quality sleep begins with solid lifestyle choices. Mayo Clinic recommends sticking to a regular sleep schedule as often as possible. This means going to bed and getting up at the same time every day and getting at least seven hours of restorative sleep. You should also maintain a healthy diet and exercise regularly to help your body regulate its circadian rhythm. Studies have shown that limiting screen time and other blue lights before bed will also help with sleep quality.
There are also several natural remedies you can use to help with sleep quality. Experts at Johns Hopkins School of Medicine suggest chamomile tea and melatonin supplements. The tea can help prepare your body for rest at the end of the day. Melatonin is a naturally occurring hormone that your body produces to help induce a sense of sleepiness and regulate your sleep-wake cycle. For those struggling with sleep apnea there are oral appliances available that can used as an alternative to CPAP therapy or more invasive procedures.
You should always consult your primary care physician before seeking sleep-related medical intervention. Most doctors will likely recommend prescription medications. These medications are most effective when used on a short-term basis and in conjunction with good lifestyle decisions. Many people also seek cognitive or behavioral treatments for disorders like chronic insomnia. If you suffer from sleep apnea you doctor may recommend a breathing device or CPAP machine in addition to lifestyle changes.
Advice from Sleep Expert Jane Wrigglesworth
Jane Wrigglesworth is a certified sleep science coach with her own private clinic, How To Sleep Well. She has studied sleep science for the past 12 years, sleep and neurobiology via Michigan University, and natural medicine and nutrition at South Pacific College of Natural Medicine. She consults with individuals and corporate groups on sleep and fatigue management and offers regular workshops. Jane is a member of the American Academy of Sleep Medicine.
Q: In your experience, what are the most common effects of sleep deprivation or erratic sleep on people working in healthcare? Do they differ from other jobs or industries?
A: Studies have shown over and over that sleep deprivation can lead to a whole host of problems, including medical errors and adverse clinical outcomes. Healthcare workers commonly show symptoms of sleep deprivation – not just fatigue or crankiness, but decreased empathy, poor cognitive assimilation and memory, slower response times, a greater number of errors, decreased ability to handle complex and stressful tasks, and a significantly increased risk of needlestick injury.
There is also an increased risk of accidents out in the field or when going home after shifts have ended. The risk for accidents increases exponentially the longer your shift. Compared with an 8-hour shift, for example, Centers for Disease Control and Prevention (CDC) state that working 10-hour shifts increases the risk for accidents and errors by 13% while working 12-hour shifts increases the risk for accidents and errors by 28%. They also state that being awake for 17 hours is similar to having a blood alcohol concentration (BAC) of 0.05% (the level some countries use for drunk driving violations). Being awake for 24 hours is similar to having a BAC of 0.10% (above the U.S. drunk driving level of 0.08).
Q: What are some concrete, practical steps healthcare students and professionals can take to mitigate those effects?
A: Pay attention to your sleep habits. It’s essential to establish a consistent sleep schedule, ideally incorporating a 7-8-hour block of sleep every 24 hours, at the same time each day. An erratic sleep schedule leads to a rise in sleep disturbances.
For those on shift work, plan for that block of sleep to be as close to night as possible to minimize circadian disruption.
Keep in mind your circadian clock gets its cues from light and dark. It uses light and dark to predict what to do next – to prepare you for being alert and active and to prepare you for sleep. It’s most sensitive to light from about 2 hours before your normal bedtime and through the night until about 1 hour before your normal wake-up time. Exposure to light during this time is likely to affect your sleep. Conversely, a quick walk around the block in the morning will help to reset your circadian rhythm and signal the brain it’s the start of a new day.
Q: Many healthcare professionals and students in the field are probably aware of the standard sleep advice most experts give to the general public. What would you say to people looking to go beyond the usual guidelines of diet, exercise, and taking melatonin every once in a while?
A: Assuming you do not have a serious sleep disorder, light exposure, diet and exercise really are key to a good night’s sleep.
I recommend padding your diet with vitamins, minerals and amino acids that support serotonin, the precursor to melatonin. Foods high in tryptophan are important, as tryptophan is necessary for the synthesis of serotonin. When limited amounts of tryptophan are ingested, reduced amounts of serotonin, melatonin, niacin and other important molecules can lead to several sleep disorders as well as depression.
Q: As a healthcare professional yourself, what piece sleep-related advice do you wish you’d been given earlier in your career?
A: Take time to wind down before bed. That means switching off all gadgets and doing something relaxing for at least an hour, preferably two, before you get into bed. I used to work very long hours, then take my work home and work right up until bedtime – 11pm, midnight or even 1am. Then I’d wonder why I couldn’t go to sleep straight away. Your mind needs time to wind down otherwise it will continue to race when you switch off the light. Likewise, your body and muscles need time to relax. If you set up a nightly wind-down routine, your body and mind register that it’s almost time for sleep.
Q: The recent COVID-19 pandemic continues to place an extraordinary amount of worldwide stress on healthcare systems and those that work around the clock to keep us safe and healthy. Quality sleep is important as ever, but healthcare professionals may feel that they have to choose between getting good sleep and providing essential services. Given all this, what would you say to professionals working during times of unprecedented crisis?
A: It’s in everyone’s interest for healthcare professionals to remain well rested so they can perform their critical duties to the highest standards and keep themselves and their patients safe. Good sleep increases productivity (poor sleep slows you down) and it reduces stress, anxiety and depression. It’s also critical for keeping your immune system functioning at its best. Insufficient sleep heightens the risk of illnesses, including influenza and the common cold, both of which, of course, are forms of coronavirus.
If days off are not possible at this time, use “no alarm days”, if possible. Sleep until you naturally wake up in the morning. Or use a buddy system. Buddies should monitor each other and employ activities to increase the alertness of their partner.
Sleep Resources, Tools, and Apps
Websites & Organizations
American Academy of Sleep Medicine
(AASM): Based in Darien, Illinois, the AASM advances sleep care and helps people enhance sleep in order to maintain personal and professional well-being. It offers clinical resources for professionals and practitioners and promotes cutting-edge research.
American Sleep Apnea Association
(ASAA): Founded in 1990, this organization works to improve the lives of sleep apnea patients through peer-support, education, advocacy, and research. It provides CPAP assistance and hosts regional learning summits.
National Center on Sleep Disorders Research
This website houses a plethora of resources on common sleep disorders and effective treatment methods. Sponsored in part by the National Heart, Lung, and Blood Institute, the site coordinates sleep and circadian research in conjunction with other federal agencies.
This nonprofit organization has acted as a prominent expert voice on sleep and sleep health since 2001. It develops advocacy programs, publishes research findings, and raises awareness on sleep deprivation.
An international association, the World Sleep Society promotes education and patient care, especially in those parts of the world with less developed sleep medicine. It publishes a periodical and houses pertinent media resources.
Social Media Groups and Influencers
Insomnia/Sleep Disorders Facebook Group
People in this forum have developed a grassroots support group for those who struggle with insomnia and other sleep disorders. Once you request to join is approved, you can participate in an ongoing discussion on how to cope with difficulties getting regular, quality sleep.
Users of this photo-sharing app often tag their posts with hashtags like #BetterSleep, #SleepTips, or #SleepBetter as a way of spreading knowledge and general advice. Some share their own sleep data, while others offer dietary tips and lifestyle strategies.
A gathering place and sounding board for all things sleep-related, this subreddit is filled with individual tips and strategies for people interested in getting good, quality sleep. Users share their own experiences struggling with sleep and offer advice to others in threaded discussions.
Sleep Review is a magazine that focuses on sleep disorders and sleep health. The publication maintains an active presence on Twitter and often links to news and recent developments in sleep medicine. Its audience ranges from clinicians and health professional to general practitioners.
YouTube offers a plethora of resources for people interested in sleep and sleep health. Organizations like Mayo Clinic often post videos with sleep tips and advice. Influencers like Michael Sealey, a sleep expert, also provide useful guides, resources, and strategies for quality sleep.
Podcasts
This podcast gives interested people short episodes full of relaxing, synesthetic sounds that encourage autonomous sensory meridian response (ASMR). For many people these sounds generate positive feeling and reduce stress.
Developed by Mary Meckley, this podcast encourages healthy sleep by offering daily, guided meditation demonstrations. It develops a theme each week by focusing on different emotions and stress triggers.
This show tells original, intentionally boring stories borrowed from popular culture, media, and literature. It delivers these stories in hourlong episodes designed to put you to sleep at the end of a long day.
This podcast provides bedtime story-telling for adults who struggle to fall asleep. In each episode host Otis Gray reads an old book in a slow, soothing voice until you peacefully drift off.
“Sleep,” Radiolab Episode (May 24, 2007)
An especially popular installment of the award-winning podcast, this episode delves into history and science of sleep. It also discusses sleep deprivation and dreaming.
Tools & Apps
Designed for Apple and PC users alike, this tool modifies the look and tone of your computer screen depending on surroundings and the time of day. It reduces the emission of blue lights that often contribute to sleep deprivation.
This tool houses a massive library of background noises and interactive soundscapes that can help you fall asleep and get a solid eight hours every night. Endorsed by both The Wall Street Journal and The New York Times, the tool also offers apps for a variety of platforms.
Users will find an array of sonic resources designed to foster healthy sleeping habits. These include meditation strategies, relaxation techniques, and a range of natural melodies proven to support quality sleep.
This app uses your smartphone’s accelerometer to track and analyze your sleep every night. It offers useful metrics and data, including sleep length, quality, and user-designated tags.
This tool offers a tiered subscription service that helps people measure the quantity and quality of their sleep over time. Users can also discover if and how frequently they snore during the night.
